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Cardiovascular effects of electronic cigarettes

The available literature suggests that electronic cigarettes (e-cigarettes), although not without risk, might decrease cardiovascular risk in long-term smokers of tobacco cigarettes who switch to e-cigarettes. However, to safeguard our youth, e-cigarettes must be required to meet product standards, all flavourings must be banned and laws regulating e-cigarette sales must be strictly enforced.

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References

  1. Moheimani, R. S. et al. Increased cardiac sympathetic activity and oxidative stress in habitual electronic cigarette users: implications for cardiovascular risk. JAMA Cardiol. 2, 278–284 (2017).

    Article  Google Scholar 

  2. Garcia, P. D., Gornbein, J. & Middlekauff, H. R. Cardiovascular autonomic effects of electronic cigarette use: a systematic review. Clin. Auton. Res. https://doi.org/10.1007/s10286-020-00683-4 (2020).

    Article  PubMed  Google Scholar 

  3. Ip, M. et al. Tobacco and electronic cigarettes adversely impact ECG indices of ventricular repolarization: implication for sudden death risk. Am. J. Physiol. Heart Circ. Physiol. https://doi.org/10.1152/ajpheart.00738.2019 (2020).

    Article  PubMed  Google Scholar 

  4. Carnevale, R. et al. Acute impact of tobacco versus electronic cigarette smoking on oxidative stress and vascular function. Chest 150, 606–612 (2016).

    Article  Google Scholar 

  5. Kelesidis, T. et al. Differential impact of chronic electronic cigarette and tobacco cigarette smoking on monocyte activation in humans [abstract]. J. Am. Coll. Cardiol. 75 (Suppl. 1), 2276 (2020).

    Article  Google Scholar 

  6. Libby, P., Nahrendorf, M. & Swirski, F. K. Leukocytes link local and systemic inflammation in ischemic cardiovascular disease: an expanded “cardiovascular continuum”. J. Am. Coll. Cardiol. 67, 1091–1103 (2016).

    Article  CAS  Google Scholar 

  7. Boas, Z. et al. Activation of the “splenocardiac axis” by electronic and tobacco cigarettes in otherwise healthy young adults. Physiol. Rep. 5, e13393 (2017).

    Article  Google Scholar 

  8. George, J. et al. Cardiovascular effects of switching from tobacco cigarettes to electronic cigarettes. J. Am. Coll. Cardiol. 74, 3112–3120 (2019).

    Article  CAS  Google Scholar 

  9. Middlekauff, H. R. et al. Differential effects of tobacco cigarettes and electronic cigarettes on endothelial function [abstract]. J. Am. Coll. Cardiol. 75 (Suppl. 1), 1858 (2020).

    Article  Google Scholar 

  10. Levy, D. T. et al. Potential deaths averted in USA by replacing cigarettes with e-cigarettes. Tob. Control 27, 18–25 (2018).

    Article  Google Scholar 

Download references

Acknowledgements

H.R.M. gratefully acknowledges receiving research grants from the Tobacco-Related Diseases Research Program (TRDRP 23XT-0006H, 25IR-0024H, 28IR-0065 and T29IP0319) that have supported the investigations included in this Comment.

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Correspondence to Holly R. Middlekauff.

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Middlekauff, H.R. Cardiovascular effects of electronic cigarettes. Nat Rev Cardiol 17, 379–381 (2020). https://doi.org/10.1038/s41569-020-0370-3

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